Cognitive processes related to problematic pornography use (PPU): A systematic review of experimental studies.

INTRODUCTION: Some people experience symptoms and negative outcomes derived from their persistent, excessive, and problematic engagement in pornography viewing (i.e., Problematic Pornography Use, PPU). Recent theoretical models have turned to different cognitive processes (e.g., inhibitory control, decision making, attentional bias, etc.) to explain the development and maintenance of PPU, but empirical evidence derived from experimental studies is still limited. In this context, the present systematic review aimed to review and compile the evidence around cognitive processes related to PPU. METHODS: A systematic review was performed in accordance with PRISMA guidelines to compile evidence regarding cognitive processes related to PPU. We retained and analyzed 21 experimental studies addressing this topic. RESULTS: Studies were focused on four cognitive processes: attentional bias, inhibitory control, working memory, and decision making. In brief, PPU is related to (a) attentional biases toward sexual stimuli, (b) deficient inhibitory control (in particular, to problems with motor response inhibition and to shift attention away from irrelevant stimuli), (c) worse performance in tasks assessing working memory, and (d) decision making impairments (in particular, to preferences for short-term small gains rather than long-term large gains, more impulsive choice patterns than non-erotica users, approach tendencies toward sexual stimuli, and inaccuracies when judging the probability and magnitude of potential outcomes under ambiguity). CONCLUSION: This systematic review offers a comprehensive overview of the current state of knowledge regarding the cognitive features related to PPU, and points out new areas that warrants further research.

Occurrence and clinical characteristics of Compulsive Sexual Behavior Disorder (CSBD): A cluster analysis in two independent community samples.

BACKGROUND AND AIMS: Compulsive Sexual Behavior Disorder (CSBD) is characterized by a persistent failure to control intense and recurrent sexual impulses, urges, and/or thoughts, resulting in repetitive sexual behavior that causes a marked impairment in important areas of functioning. Despite its recent inclusion in the forthcoming ICD-11, concerns regarding its assessment, diagnosis, prevalence or clinical characteristics remain. The purpose of this study was to identify participants displaying CSBD through a novel data-driven approach in two independent samples and outline their sociodemographic, sexual, and clinical profile. METHODS: Sample 1 included 1,581 university students (females = 56.9%; Mage = 20.58) whereas sample 2 comprised 1,318 community members (females = 43.6%; Mage = 32.37). First, we developed a new composite index to assess the whole range of CSBD symptoms based on three previously validated scales. Based on this new composite index, we subsequently identified individuals with CSBD through a cluster analytic approach. RESULTS: The estimated occurrence of CSBD was 10.12% in sample 1 and 7.81% in sample 2. Participants with CSBD were mostly heterosexual males, younger than respondents without CSBD, reported higher levels of sexual sensation seeking and erotophilia, an increased offline and especially online sexual activity, more depressive and anxious symptoms, and poorer self-esteem. CONCLUSIONS: This research provides further evidence on the occurrence of CSBD based on an alternative data-driven approach, as well as a detailed and nuanced description of the sociodemographic, sexual, and clinical profile of adults with this condition. Clinical implications derived from these findings are discussed in detail.

Psychiatric comorbidity in compulsive sexual behavior disorder (CSBD).

Compulsive Sexual Behavior Disorder (CSBD) is characterized by a persistent failure to control intense and recurrent sexual impulses, urges, and/or thoughts, resulting in repetitive sexual behavior that causes a marked impairment in important areas of functioning. Data collected from clinical populations suggest that CSBD frequently co-occurs with other Axis I and II psychiatric disorders; however, studies conducted so far suffer from methodological shortcomings that prevent the determination of accurate psychiatric comorbidity rates (e.g., small sample sizes, reliance on non-reliable assessment methods in the estimation of comorbidity or the non-inclusion of healthy individuals to compare prevalence rates). The purpose of this study was to explore psychiatric comorbidity in a sample of individuals with and without CSBD. The study sample comprised 383 participants distributed into two groups through a cluster analyses: 315 participants without CSBD (non-CSBD) and 68 qualifying as sexually compulsives (CSBD). Participants were assessed for co-occurring Axis I and II clinical conditions using structured clinical interviews for the DSM-IV (SCID-I and II). The majority of CSBD participants (91.2%) met the criteria for at least one Axis I disorder, compared to 66% in non-CSBD participants. CSBD participants were more likely to report an increased prevalence of alcohol dependence (16.2%), alcohol abuse (44%), major depressive disorder (39.7%), bulimia nervosa (5.9%), adjustment disorders (20.6%), and other substances -mainly cannabis and cocaine- abuse or dependence (22.1%). Concerning Axis II, prevalence of borderline personality disorder was significantly higher in CSBD participants (5.9%). As expected, prevalence of different psychiatric conditions was significantly increased among sexually compulsive participants, revealing comorbidity patterns with important implications in the conceptualization, assessment, and treatment of patients with CSBD.

Validation of the AIDS Prevention Questionnaire: A Brief Self-Report Instrument to Assess Risk of HIV Infection and Guide Behavioral Change.

This paper describes the process of building and validating the AIDS Prevention Questionnaire (CPS), a brief HIV risk assessment measure. An initial 64-items bank was filled out by 466 young people (192 men and 274 women), aged between 17 and 26 years (M = 20.62; SD = 2.15). The exploratory factor analysis revealed five components: Knowledge about HIV, Condom Attitudes, Intentions of Condom Use, Safe sexual behavior and Stigma and discrimination towards people living with HIV. This structure was confirmed by confirmatory factor analysis. The internal consistency for the different components ranged from .67 to .74. Moreover, CPS has a classification system that allows determining the level of risk. These results support the AIDS Prevention Questionnaire as a valid and reliable measure to detect earlier the risk for HIV infection and to design adjusted preventive interventions.

HIV prevention interventions for young male commercial sex workers.

The sex industry, where men sell sexual services to other men or women, has grown in recent years. These men who offer sexual services are particularly vulnerable to HIV infection due to such factors as: frequency of risky sexual practices, number of sex partners, drug-taking, prevalence of sexually-transmitted infections (STI) and their specific situation of social exclusion which may hinder access to health services. These multi-faceted realities faced by sex workers explain the burgeoning interest in new avenues of scientific research. There are too few preventive programs however aimed at this population group and the studies that evaluate their effectiveness are fewer still. In this article we survey more recent studies on the difficulties of implementing programs for HIV prevention in male sex workers (MSW), as well as the studies that have gauged the impact of preventive programs in this group.

[Anesthesiologic implications of moyamoya disease]. / Implicaciones anestésicas en la enfermedad de moyamoya.

A 34-year-old woman 22 weeks pregnant suffered cerebral hemorrhage, requiring admission to the intensive care unit and mechanical ventilation. She recovered without sequelae. The diagnosis was moyamoya disease and she was scheduled for elective cesarean delivery at 38 weeks of gestation. After appropriate preoperative study and complementary testing (echocardiogram, computerized axial tomography of the brain and determination of anti-cardiolipin and other antibodies, which were normal) the patient was given intradural anesthesia with 15 mg of 0.5% bupivacaine and 24 micrograms of fentanyl, with continuous monitoring of blood pressure, tympanic temperature and neurological variables. Warm intravenous fluids and ephedrine (100 to 250 micrograms/min) were perfused. No noteworthy neurological events or hemodynamic changes occurred during or after surgery. Postoperative analgesia was provided with 2 mg/12 h of morphine through an epidural catheter.